Update: Interim Guidance for Health Care Professionals Evaluating and Caring for Patients with Suspected E-cigarette, or Vaping, Product Use–Associated Lung Injury and for Reducing the Risk for Rehospitalization and Death Following Hospital Discharge — United States, December 2019

Characteristics of Patients Experiencing Rehospitalization or Death After Hospital Discharge in a Nationwide Outbreak of E-cigarette, or Vaping, Product Use–Associated Lung Injury — United States, 2019

“…At least one quarter of rehospitalizations occurred within 2 days of initial discharge, which suggests that ensuring clinical stability before discharge as well as postdischarge follow-up optimally within 48 hours might minimize risk for rehospitalization and death, especially among patients with chronic conditions (5). A higher frequency of rehospitalizations among EVALI patients after a longer interval has been reported elsewhere (6); differences observed in the current study might reflect its larger study population and wider geographic distribution of EVALI cases.…”

“…EVALI patients who died also were more likely to have been admitted to an intensive care unit, experienced respiratory failure necessitating intubation and mechanical ventilation, and were significantly older. EVALI patients with chronic comorbidities and these initial hospitalization characteristics might require a higher threshold for hospital discharge and focused efforts during discharge planning and transition to the outpatient setting, such as intensive case management and rapid follow-up (5).…”

“…A higher frequency of rehospitalizations among EVALI patients after a longer interval has been reported elsewhere (6); differences observed in the current study might reflect its larger study population and wider geographic distribution of EVALI cases. Concurrent with this report, CDC is publishing additional clinical guidance for discharge planning for EVALI patients (5).…”

“…EVALI patient follow-up optimally within 48 hours after hospital discharge might minimize risk for rehospitalization and death, especially among patients with chronic conditions. In addition, interventions for EVALI patients, including intensive hospital discharge planning and optimized case management, might minimize risks for morbidity and mortality after a hospital discharge (5).…”

E-cigarette, or Vaping, Product Use-associated Lung Injury (EVALI): Acute Lung Illness within Hours of Switching from Traditional to E-cigarettes

“…In a patient with product use, respiratory symptoms, a negative chest radiograph, and clinical suspicion of lung injury, a CT scan of the chest can provide diagnostic value [7]. Consider admission for patients with respiratory distress, O2 saturation below 95% on room air, or concern for lung injury from ecigarettes used within the preceding 90 days, while many EVALI patients have had persistent hypoxemia requiring home oxygen and bronchodilators at discharge, long-term effects are unknown, and follow-up is strongly advised [3,8]. Despite the scarcity of reported short-and long-term adverse effects from these products, animal and observational studies and a few clinical trials have tried to fill this gap, finding numerous adverse effects from these products.…”